Validation of a Realistic Simulator for Veterinary Gastrointestinal Endoscopy Training

Abstract

This article reports on the face, content, and construct validity of a new realistic composite simulator (Simuldog) used to provide training in canine gastrointestinal flexible endoscopy. The basic endoscopic procedures performed on the simulator were esophagogastroduodenoscopy (EGD), gastric biopsy (GB), and gastric foreign body removal (FBR). Construct validity was assessed by comparing the performance of novices (final-year veterinary students and recent graduates without endoscopic experience, n=30) versus experienced subjects (doctors in veterinary medicine who had performed more than 50 clinical upper gastrointestinal endoscopic procedures as a surgeon, n=15). Tasks were scored based on completion time, and specific rating scales were developed to assess performance. Internal consistency and inter-rater agreement were assessed. Face and content validity were determined using a 5-point Likert-type scale questionnaire. The novices needed considerably more time than the experts to perform EGD, GB, and FBR, and their performance scores were significantly lower (p<.010). Inter-rater agreement and the internal validity of the rating scales were good. Face validity was excellent, and both groups agreed that the endoscopy scenarios were very realistic. The experts highly valued the usefulness of Simuldog for veterinary training and as a tool for assessing endoscopic skills. Simuldog is the first validated model specifically developed to be used as a training tool for endoscopy techniques in small animals.

Teaching of diagnostic skills in equine gynecology: Simulator-based training versus schooling on live horses

“…Success of skills training in surgery, dentistry, and endoscopy has been assessed by determining to what extent simulator training improved the performance on the simulator [6][7][8][9] or simulators were compared to theoretical training only [5]. In two studies assessing surgical procedures, students trained on a model of the canine female genital tract were better in performing ovariohysterectomies on live dogs than students trained on canine cadavers [15].…”

“…The veterinary profession itself has been pivotal in developing alternatives to skills training on live animals. Simulation models have become available for a range of procedures in small animal surgery [5,6], dentistry [7], endoscopy [8], emergency resuscitation [9] and for transrectal palpation of the genital tract in cattle [10]. Some simulators use haptic technologies with the construction of virtual objects to reproduce the tactile sensations experienced when performing the procedure [11].…”

Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats

“…The experience level of the endoscopist or ability to adequately visualize the colonic mucosa also could contribute to the occurrence of perforations. Technical ability differs markedly between experienced and novice veterinary endoscopists, 26 and gastroenterologists in human medicine are not considered competent at ileoscopy until after completion of extensive training, including intubating the ileum at least 50 times. 27 In our series, the majority (n = 10) of perforations were experienced by interns or residents, which might have been influenced by reporting bias.…”

Visuospatial skills are better predictors than dexterity for basic ultrasonographic and fluoroscopic skills in veterinary students

“…In medical education, the traditional model of learning is based on observing and participating in live procedures, which is limited by the number of procedures available to trainees and the risk of harm to patients . Procedural training simulators have gained popularity as they allow trainees to improve technical skill and develop confidence in a controlled environment without risk of harm to patients . Skills acquired with simulators may lead to improved performance in live‐patient procedures .…”

“…Procedural training simulators have gained popularity as they allow trainees to improve technical skill and develop confidence in a controlled environment without risk of harm to patients . Skills acquired with simulators may lead to improved performance in live‐patient procedures . Previous studies in human medicine have used simulators to assess the possibility of predicting ultrasound, endovascular, and laparoscopic surgical performance by testing innate visuospatial and psychomotor aptitude .…”